Singapore's billion-dollar headache

Kok Xinghui

SINGAPORE (Sept 18): How much does a migraine cost? The type of throbbing headaches cost Singapore some $1.04 billion last year, according to new research released Wednesday by the DUKE-NUS Medical School and Novartis.

A whopping 80% of that cost came from a loss of productivity due to missed workdays or impacts on capacity to carry out daily jobs, while the remainder was from medical tests and consultations.

The study took in responses from 606 migraine patients in Singapore and found that, on average, respondents missed 9.8 days of work a year due to migraine.

For those who did show up at work despite splitting headaches, the symptoms of migraine greatly reduced their ability to perform their tasks, causing losses in productivity time of about 7.4 days a year.

Dr Eric Finkelstein, Professor at the Health Services and Systems Research Programme at Duke-NUS Medical School and co-author of the study, says the results show that the impact of migraine goes beyond the individual.

“While it significantly affects the patient’s quality of life, it can also have a substantial economic impact on their work-life – and, as a result, the wider economy – as people with migraine may take medical leave or miss work due to an episode. If they do go to work, they have decreased productivity levels,” he says.

Migraine is a common and recurrent neurological disorder characterized by unilateral headaches of moderate to severe intensity that typically last between 4 and 72 hours. It is often accompanied by a wide array of symptoms such as nausea, sensitivity to light, sound and routine physical activity. It mostly affects individuals aged 30 to 40, with approximately 90% of people with migraine experiencing their first attack before age 40.

In Singapore, migraine affects up to 10% of the population, or approximately 330,000 people, with about 100 new patients added to the number every month at the patient referral clinic for headache disorders at the National University Hospital (NUH).

Alarmingly, the study found that one in four patients here did not seek medical treatment for their migraines.

“For those who do try to manage the condition, they typically resorted to acute medications which may not be the most effective strategy in the long term, adding to their overall healthcare costs,” says Dr Jonathan Jia Yuan Ong, President of the Headache Society of Singapore and Consultant, Division of Neurology, National University Hospital.

Looking at spending patterns, the study also found that there is a need for more accurate diagnoses and effective treatment. The largest contributor to participants’ healthcare costs was medical tests (41%), followed by alternative medications (18%), consultations (16%), hospitalisations (13%) and medications (11%).

Celine Landie, Managing Director, Novartis Singapore and Asian Emerging Markets, says that given the cost and productivity losses, the study indicates that current coping strategies adopted by patients are ineffective.

She says public and private organisations and employers must explore options together, such as designing more supportive work policies or driving workplace culture changes that educate the workforce about the condition.

“By ensuring patients and physicians are aware of the options available to support them in managing the condition, we can also make a significant step in alleviating the impact of the affected people,” Landie says.

Researchers behind the study are hopeful that the $1.04 billion price tag on migraine will drive further research into this health issue, catalyse conversations and support measures towards addressing the problem.

Otherwise, Singapore will be left with a labour productivity headache.